Breaking News
January 21, 2019 - FDA Advisory Committee Votes on Zynquista (sotagliflozin) as Treatment for Adults with Type 1 Diabetes
January 21, 2019 - The causes and complications of snoring
January 21, 2019 - Placenta adapts and compensates when pregnant mothers have poor diets or low oxygen
January 21, 2019 - New implant could restore the transmission of electrical signals in injured central nervous system
January 21, 2019 - Rapid-acting fentanyl test strips found to be effective at reducing overdose risk
January 21, 2019 - Coronary Artery Calcium May Help Predict CVD in South Asians
January 21, 2019 - The mystery of the super-ager
January 21, 2019 - Scientists develop smart microrobots that can change shape depending on their surroundings
January 21, 2019 - Keep Moving to Keep Brain Sharp in Old Age
January 21, 2019 - Despite progress, gay fathers and their children still structurally stigmatized
January 21, 2019 - Merck recognized with 2018 Life Science Industry Award for best use of social media
January 21, 2019 - Coeur Wallis equips the canton of Valais with 260 SCHILLER defibrillators
January 21, 2019 - Scientists propose quick and pain-free method for diagnosing kidney cancer
January 21, 2019 - Signs of memory loss could point to hearing issues
January 21, 2019 - HeartFlow Analysis shows highest diagnostic performance for detecting coronary artery disease
January 21, 2019 - How Much Caffeine is Too Much?
January 21, 2019 - Take a timeout before you force your child to apologize
January 21, 2019 - Scientists design two AI algorithms to improve early detection of cognitive impairment
January 21, 2019 - Novel therapy for children with chronic hormone deficiency provides lifeline for parents
January 21, 2019 - Bioethicists call for oversight of poorly regulated, consumer-grade neurotechnology products
January 21, 2019 - Study shows hereditary hemochromatosis behind many cancers and joint diseases
January 21, 2019 - Short bouts of stairclimbing throughout the day can improve cardiovascular health
January 20, 2019 - Liver Transplant Survival May Improve With Race Matching
January 20, 2019 - Study implicates hyperactive immune system in aging brain disorders
January 20, 2019 - Cancer Diagnosis May Quadruple Suicide Risk
January 20, 2019 - Parkinson’s disease experts devise a roadmap
January 20, 2019 - Research brings new hope to treating degenerative brain diseases
January 20, 2019 - Scientists pinpoint a set of molecules that wire the body weight center of the brain
January 20, 2019 - Researchers get close to developing elusive blood test for Alzheimer’s disease
January 20, 2019 - UCLA researchers demonstrate new technique to develop cancer-fighting T cells
January 20, 2019 - Researchers discover how cancer cells avoid genetic meltdown
January 20, 2019 - Exercise makes even the ‘still overweight’ healthier: study
January 20, 2019 - University of Utah to establish first-of-its-kind dark sky studies minor in the US
January 20, 2019 - School-based nutritional programs reduce student obesity
January 20, 2019 - Improved maternity care practices in the southern U.S. reduce racial inequities in breastfeeding
January 20, 2019 - New enzyme biomarker test indicates diseases and bacterial contamination
January 20, 2019 - Republican and Democratic governors have different visions to transform health care, say researchers
January 20, 2019 - Researchers discover that spin flips happen in only half a picosecond in the course of a chemical reaction
January 20, 2019 - Suicide Risk Up More Than Fourfold for Cancer Patients
January 20, 2019 - Doctors find 122 nails in Ethiopian’s stomach
January 20, 2019 - UV disinfection technology eliminates up to 97.7% of pathogens in operating rooms
January 20, 2019 - Researchers discover mechanism which drives leukemia cell growth
January 20, 2019 - AHA: Infection as a Baby Led to Heart Valve Surgery for Teen
January 20, 2019 - Injection improves vision in a form of childhood blindness
January 20, 2019 - Multiple sclerosis therapies delay progression of disability
January 20, 2019 - New study finds infrequent helmet use among bike share riders
January 20, 2019 - Clearing up information about corneal dystrophies
January 20, 2019 - Researchers describe new behavior in energy metabolism that refutes existing evidence
January 20, 2019 - New study takes first step toward treating endometriosis
January 20, 2019 - Researchers find how GREB1 gene promotes resistance to prostate cancer treatments
January 20, 2019 - Replacing Sitting Time With Activity Lowers Mortality Risk
January 20, 2019 - A simple, inexpensive intervention makes birth safer for moms and babies in parts of Africa
January 19, 2019 - New anti-inflammatory compound acts as ‘surge protector’ to reduce cancer growth
January 19, 2019 - Significant flaws found in recently released forensic software
January 19, 2019 - New Leash on Life? Staying Slim Keeps Pooches Happy, Healthy
January 19, 2019 - Men and women remember pain differently
January 19, 2019 - Rising air pollution linked with increased ER visits for breathing problems
January 19, 2019 - Study uses local data to model food consumption patterns among Seattle residents
January 19, 2019 - The brain’s cerebellum plays role in controlling reward and social behaviors, study shows
January 19, 2019 - Relationship between nurse work environment and patient safety
January 19, 2019 - Pioneering surgery restores movement to children paralyzed by acute flaccid myelitis
January 19, 2019 - Genetic variants linked with risk tolerance and risky behaviors
January 19, 2019 - New research provides better understanding of our early human ancestors
January 19, 2019 - First-ever tailored reporting guidance to improve patient care and outcomes
January 19, 2019 - 4.6 percent of Massachusetts residents have opioid use disorder
January 19, 2019 - New study suggests vital exhaustion as risk factor for dementia
January 19, 2019 - New antibiotic discovery heralds breakthrough in the fight against drug-resistant bacteria
January 19, 2019 - Ural Federal University scientists synthesize a group of multi-purpose fluorophores
January 19, 2019 - Researchers identify new therapeutic target in the fight against chronic liver diseases
January 19, 2019 - Preparation, characterization of Soyasapogenol B loaded onto functionalized MWCNTs
January 19, 2019 - FDA Approves Ontruzant (trastuzumab-dttb), a Biosimilar to Herceptin
January 19, 2019 - Tobacco use linked with higher use of opioids and sedatives
January 19, 2019 - Study delves deeper into developmental dyslexia
January 19, 2019 - Anti-vaccination movement one of the top health threats in 2019 says WHO
January 19, 2019 - Newly developed risk score more effective at identifying type 1 diabetes
January 19, 2019 - Highly effective protocol to prepare cannabis samples for THC/CBD analysis
January 19, 2019 - Prinston Pharmaceutical Inc. Issues Voluntary Nationwide Recall of Irbesartan and Irbesartan HCTZ Tablets Due to Detection of a Trace Amount of Unexpected Impurity, N-Nitrosodiethylamine (NDEA) in the Products
January 19, 2019 - How does solid stress from brain tumors cause neuronal loss, neurologic dysfunction?
January 19, 2019 - $14.7 million partnership to supercharge vaccine development
January 19, 2019 - Ian Fotheringham receives Charles Tennant Memorial Lecture award
Radiation therapy can lower risk of breast cancer recurrence in patients with ‘good risk’ DCIS

Radiation therapy can lower risk of breast cancer recurrence in patients with ‘good risk’ DCIS

image_pdfDownload PDFimage_print

A subset of patients with low-risk breast cancer is highly unlikely to see cancer return following breast conservation surgery but can lower that risk even further with radiation therapy, finds a new long-term clinical trial report. These 12-year follow-up data from the only prospective, randomized trial to compare recurrence outcomes after treatment for low-risk ductal carcinoma in situ (DCIS) were presented last week at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO).

In this long-term update, patients with “good risk” DCIS — defined by the research team as cancer found only on mammogram or incidentally during a breast biopsy for another reason — continued to experience extremely low recurrence 12 years after breast conservation surgery. Those who underwent whole breast radiation therapy (WBRT) and those who also opted to take tamoxifen experienced the lowest recurrence rates, but even those who received no further treatment following surgery did not experience any life-threatening consequences.

“I think the most surprising thing was that the recurrence rate in patients randomized to receive radiation therapy was so low. Radiation reduced recurrence by more than 70 percent, and this was a much more profound impact than we expected,” said Beryl McCormick, MD, FASTRO, lead investigator of the NRG Oncology/RTOG multi-center trial, Chief of the External Beam Radiotherapy Service at Memorial Sloan Kettering Cancer Center and a professor of radiation oncology at Cornell University in New York.

Since none of the tumors that recurred in either group appeared to pose a life-threatening risk, however, Dr. McCormick said it was reasonable for patients to determine, in consultation with their physician, whether continued treatment following surgery was something they wanted to do.

“Not all DCIS is the same,” said Dr. McCormick. “This type of cancer will not impact life expectancy. We found that radiation does significantly reduce the risk for recurrence, but you are starting with an extremely low recurrence rate even without radiation. Therefore, there should be a meaningful discussion between patient and doctor about whether additional treatment is something the patient wishes to pursue.”

DCIS is a cancer of the cells that line the milk ducts of the breast. It accounts for roughly one-fourth of all new breast cancers for an estimated 60,000 cases diagnosed in the United States each year. The current

Eligible tumors were 2.5 centimeters (cm) or smaller, with margins of three millimeters or less, and of low or intermediate nuclear grade. From 1999 to 2006, 636 patients were randomly assigned to receive WBRT with standard doses or to an observation arm. The use of tamoxifen for five years was optional. Initial results, including seven years of follow-up, were reported in 2013 and

The new analyses include long-term follow-up data for 629 patients whose median age was 58 years, including 76 percent post-menopausal women. Mean pathological tumor size was 0.60 centimeters (61 percent 0.5 cm or smaller, 65 percent with a margin width of 1.0 cm or larger or a completely negative re-excision specimen). The highest nuclear tumor grade was 1, found in 44 percent of patients; grade-2 tumors were diagnosed in the remaining 56 percent. Tamoxifen was used by 58 percent of patients on the WBRT arm and 65 percent of those on the observation arm (p=0.05).

Median follow-up time was 12.4 years. After 12 years, the cumulative incidence of local recurrence was 2.8 percent (95% CI 1.1, 5.6) for those in the WBRT arm and 11.4 percent (7.7, 15.8) for those in the observation arm (hazard ratio (HR) 0.26, 95% CI 0.13, 0.54; p=0.0001). The 12-year cumulative incidence of invasive local recurrence was 1.5 percent (95% CI 0.4, 4.0) for those in the WBRT arm and 5.8 percent (3.2, 9.5) for those who did not receive radiation (HR 0.34, 95% CI 0.14, 0.85; p=0.016).

In multivariate analysis, only those who received both WBRT (HR 0.25, 95% CI 0.12, 0.53; p=0.0003) and tamoxifen (HR 0.50, 95% CI 0.27, 0.91; p=0.024) experienced reduced local recurrence. Neither age nor pathological tumor size were significant for predicting local recurrence or invasive local recurrence. There were no significant differences between treatment arms for overall survival, disease-free survival or mastectomy use.

During the additional five years following surgery, noted Dr. McCormick, “there was a slight creeping up of local recurrence rate.” For those who received WBRT, the rate increased by just under 1 percent, bringing it to nearly 3 percent post-surgery. For those who did not receive radiation, the recurrence rate increased by one percentage point each additional year of follow-up, climbing from just under 7 percent to just under 12 percent after 12 years.

These results “should inform a meaningful patient-physician discussion that includes risks, benefits and the patient’s own degree of comfort,” Dr. McCormick concluded.

“All of us have a different definition of what is an acceptable risk,” she said. “Some patients with DCIS will still want radiation therapy. But for others, the risk is so low they may opt not to treat, and that should be considered a viable option.”

Source:

https://www.astro.org/News-and-Publications/News-and-Media-Center/News-Releases/2018/Radiation-therapy-cuts-low-risk-of-recurrence-by-n

Tagged with:

About author

Related Articles